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Fillers or Botox for Lines Showing Only when Laughing or Smiling?

My laugh lines are only apparent when I smile or laugh. Is it still ok for me to use Juvederm or Restylane, or do I have to use Botox?

Doctor Answers (14)

Why do you want to eliminate your smile lines?

+3

Dear Arnj

I really don't blame you for thinking that you should have your smile lines eliminated. I think that we doctors are responsible for this type of thinking. After all, many doctors think that the purpose of BOTOX is to eliminate lines. In fact some use as their before and after picture an image of their patient wadding up the worry line area before BOTOX treatment and then being unable to make this wadding effort after treatment.

This is really a misguided concept of what this treatment is all about. The goal needs to be aesthetic improvement not line annihilation. 90% of the time our faces are at rest. The goal is improvement in lines that are present at rest not lines that are only present dynamically. The issue is that you are supposed to have lines in your face when you make expressions. When you don't people will not trust you. These lines are a critical element of how we communicate. Without the appropriate facial indicators, you will appear insincere or not trust worthy. In particular it is normal to heap up lines when we smile. This is called a Duchenne smile and it tells people that you are actually happy. When you smile and don't make these lines, the smile looks insincere-think of those fake smiles on airline attendants.

So improvement of some lines is OK but be careful of what you wish for. Don't have treatment that will make you look insincere and untrust worthy. This is why you need to go to a practitioner who knows what they are doing.


Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Botox and fillers for lines with animation

+2

Botox is great for lines on your forehead and around your eyes whenever you laugh or animate these areas. However, if you use fillers for lines that only occur with animation, you may be able to see small bumps when you aren't moving those parts of your face. Check out some before and after pictures before trying either one.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 67 reviews

Fillers are for "resting wrinkles", Botox softens "active" ones.

+1

If you only see the lines/wrinkles when you are moving the muscles of your face, then weakening the muscles should soften the wrinkles...You do not say where the "laugh lines" that you want addressed are- if they are around your eyes, Botox or Dysport is appropriate, if they are around your mouth, like the nasolabial folds, then Botox is not appropriate, (it would paralyze your smile), and in this location fillers are the way to go.

Debra Irizarry, MD
Crestone Plastic Surgeon
5.0 out of 5 stars 3 reviews

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Botox or Fillers for Lines When Smiling?

+1

Hi ARNJ.  The answer to your question about which product to use for your lines is dependent on the area of the face you are concerned with rather than whether or not you see the lines while you are smiling and laughing.

If you are concerned about the lines that run vertically from the corner of your nose to the corner of your mouth, then this is an area to consider Radiesse or one  the HA dermal fillers like Restylane, Juvederm or Perlane. 

If the area you are concerned with is the crow's feet area (outer edges of the eyes) then Botox is the injection product for you. 

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Treatment of laugh lines

+1

If you are referring to the lines near the lower crow’s feet that are noticable when you smile, Botox can help only a little as the doctor doesn’t want to make your mouth muscles go to sleep and create problems eating and with speech. Fillers may look too noticable here. A combination of conservative amounts of Botox and resurfacing, such as with Fraxel, may help but this is an area that many people just have to accept creases when they smile.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Botox or Filler

+1

In general I, botox is used for areas around the eyes and between the eyes and the forehead. There are some exceptions as botox can be used for neck banding and the lines around the lips.

As far as laugh lines or the lines around the corner of the mouth or the marrionette lines, the best treatment is to fill the lines with a filler like Restylane, Juvederm, Perlane or Radiesse. When I say the laugh lines, I mean the nasolabial fold.

Hope that answers your questions.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 31 reviews

Maybe Nothing At All

+1

If you see these lines only when laughing or smiling you may not need them treated at all. I would only bother treating lines you see at rest. You do want some dynamism of your face, smiling and laughing are good things. I would wait until you begin to notice lines at rest and in the meantime practice good skin care.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
5.0 out of 5 stars 7 reviews

Botox or Fillers for Laugh Lines?

+1

Hi Arnj,

Botox should be used for facial lines in the upper 1/3 of the face (forehead, crow's feet, bunny lines on the upper nose) that appear with facial expression and muscle movement.

For "laugh lines" from the nose to the mouth (nasolabial folds, lines), fillers such as Juvederm, Restylane, or Evolence are best used.

Choose your injecting physician carefully.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Botox or filler for laugh lines

+1

Since you state that the lines are only present when you laugh or smile, I would recommend Botox.  You do not want to eradicate these lines completely since you also want it to look natural with facial expressions.  Make sure your physician is experienced in use of Botox throught the face. 

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 7 reviews

Fillers or Botox for dynamic lines

+1

It would depend WHERE the lines are and HOW DEEP they are.

If by laugh lines you refer to the crow's feet lines just to the side of the corners of the eyes - Botox does a GREAT job on smoothing these. Fillers would be needed only after you saw the extent of smoothing obtained by Botox (not commonly needed).

If on the other hand, you refer to the lines between the corners of the nose and corners of the mouth (nasolabial folds) or other perioral lines, I would use Botox very sparingly and only in certain classes of people (such as those with gummy smiles) and treat the many others with various combinations of fillers: Juvederm, Restylane, Perlane.

I hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.